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Making Medicaid Work for Patients and States

HHS Secretary Price and CMS Administrator Verma sent a letter to states expressing openness to new ideas that would improve access to care for patients in the Medicaid program.

Doctor checking blood pressure

Medicaid is America’s largest health care program. A joint federal-state system, it covers about one in every four Americans, or nearly 75 million of us.

Too often, though, Medicaid fails to provide patients with real access to high-quality care, in part because the federal government sets one-size-fits-all rules for how states should run their Medicaid programs.

HHS has now announced a firm commitment to letting states develop new solutions that work for their unique Medicaid populations.

On March 14, Secretary Price and Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma sent a letter to America’s 50 governors laying out a vision for a new era of partnership for Medicaid innovation.

They encouraged the states to come up with ideas of their own for the program and offered some specific suggestions.

Some of the ideas:

  • Introducing plans that include Health Savings Account–like features, to give Medicaid patients real control over their health care spending and choices;
  • Finding ways to encourage people on Medicaid to secure employer-provided insurance;
  • Breaking down barriers that force members of the same family onto different Medicaid plans;
  • Requiring small premiums, or other contributions from patients, to encourage personal responsibility and ownership of their health and health care;
  • Developing ideas that encourage patients to seek care somewhere other than the emergency room, since the ER often serves patients poorly at higher cost; and
  • Promoting personal responsibility by encouraging people to take charge of their health care and enroll in the program before they have a medical emergency.

The letter also noted that HHS would be open to states proposing work requirements for some Medicaid recipients, an approach that has produced proven results for Americans enrolled in other federal, state, and local programs.

The letter also commits to several other specific actions:

  1. CMS will work with states on Medicaid initiatives to help address the tragic opioid epidemic, partly through new coverage for mental health and addiction treatment.
  2. CMS will work toward giving states extra time and flexibility to comply with what’s called the “Home and Community-Based Services rule.” The rule governs the settings in which Medicaid serves disabled Americans, with a special focus on making sure the patients are integrated into the local community. HHS is committed to ensuring that patients and families get support for settings that fit their needs.
  3. CMS will be simplifying and expediting the process the federal government uses to approve state innovations in Medicaid, which typically require approval of a waiver or demonstration project.

Ideas like these will help states provide quality care through Medicaid, which will be good for patients — especially America’s most vulnerable — and good for taxpayers.

Read the letter

Posted In: 
Health Insurance Reform